Background: Since the COVID-19 pandemic bringing a series of problems, global efforts are underway to develop the COVID-19 vaccine. Under the background of Infodemic, the negative information of the vaccine has become an issue that cannot be avoided. While the relevant information has attracted great attention, it has brought troubles to the public and exacerbated the phenomena of vaccine hesitancy, especially among parents. At present, as the pandemic continues all around the world, the vaccination among the children has been highly concerned in many countries. Based on the information adoption theory, this study aimed to develop a theoretical framework to investigate the impacts of five important factors leading to parental vaccine hesitancy, including negative information, vaccine literacy, perceived efficacy, risk perception and information adoption.

Method: An online survey was conducted in China to test the proposed research model, with a target population of which Chinese parents whose children aged 3-17. The survey was conducted between July and August 2021, when COVID-19 vaccination was just launching for children and they were optional to uptake. The survey data was collected via an online platform of Wenjuanxing with random sampling method. The final sample consists of 814 Chinese parents with diverse demographic characteristics in age, gender, occupation, and geographic location. Structural equation model (SEM) is applied to test the proposed model predicting parental COVID-19 vaccine hesitancy.

Findings: Results indicated that the COVID-19 vaccine hesitancy is highly prevalent among the Chinese parents. Meanwhile, exposure to negative vaccine information triggered a high-risk perception among respondents (b = 0.453, p < .001), which would lead to negative emotional reactions such as fear and anxiety and eventually aggravated vaccine hesitancy (b= 0.509, p < .001). In addition, the perception of information efficacy positively affected information adoption (b = 0.280, p < .001), which helped alleviate vaccine hesitancy (b = -0.145, p < .001). Furthermore, information adoption was negatively associated with vaccine hesitancy (b = -0.219, p < .001), with the moderation of vaccine literacy in this relationship (b = -0.096, p < .001). Therefore, the critical role of vaccine literacy was highlighted in the proposed model predicting parental vaccine hesitancy.

Discussion: It is one of the few studies which examined how the media exposure and the adoption of negative vaccine information affected the vaccine hesitancy among Chinese parents. We found that the negative reports on foreign vaccines from media have contributed to the vaccination hesitancy of Chinese parents. From the theoretical perspective, the critical role of negative information was emphasized during the development of parental vaccine hesitancy, together with other factors such as information adoption. Moreover, it suggested that vaccine literacy played a crucial role in promoting information reception and reducing vaccine hesitancy. The study adopted and extended the information adoption model, and discussed the factors influencing on parental vaccine hesitancy. Findings of this study could provide evidence for the applicability of information adoption theory in vaccine hesitancy study. From the practical perspective, it offers insightful recommendations for the media and public to develop effective strategies for disclosing double-sided information, and ensuring the effectiveness of information dissemination, and improving the parental of vaccine literacy.